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Reactions to trauma

There is no 'right' or 'best' way to respond to a traumatic event. And not all the effects of trauma are necessarily bad. Some people move on relatively easily and quickly from trauma and some seem to take longer. Some people find that the traumatic event brings them closer to others. Some people may feel the need to withdraw and they struggle to come to terms with the event. These are all within the range of human responses and are all valid responses. Having said that, most people can and do get over trauma.

The hallmarks of trauma are a loss of a sense of safety and control, and a difficulty in giving meaning to the event in the broader context of one's life. Many of the adverse effects of a traumatic event such as repeatedly thinking about the event, withdrawing from others, or denying that anything significant happened, are actually attempts to deal with these two factors. There can be a range of physical effects as well such as disturbed sleep, headaches, nausea, and so on that may require management.

Processing trauma

Each person is individual and there are many ways to move on and get over trauma. One of the first suggestions then is to just let yourself feel what you feel, think what you think, and so on, without trying to judge it, fix it or correct it or be bamboozled by experts who think they know more about your trauma experience and recovery than you do. Be discriminating about advice - beware of claims "miracle cures" and the claims of sceptics. Try things and do what works for you.

Many people resolve trauma not by revisiting the past, but by connecting to a future with possibilities and meaning. You might try linking the post-trauma experience to things that help move you into the future. For example, every time you catch yourself recalling the event, you could take one action that might move you a little way toward your preferred future. Find something, a goal, a project, a resolution, something that gets you through the day, the night or the next year by giving you a sense of hope and possibility for the future. Then do one thing associated with that future. Another way of putting yourself in the future is to ask yourself what would you like to be able to say in three years time about the way you got through this time.

Some people find it useful to contribute to the world or other people in order to move on or deal with traumatic events. Supporting a community response to the trauma event, joining with others who are in the same boat, helping feed and support rescue workers, and the like, may be difficult and upsetting at times, but then people know they are doing something that contributes to their and others healing which can be profoundly uplifting even in the midst of tragedy.

Establishing or reestablishing normal routines and healthy behaviours helps to manage the stress associated with a traumatic event. Regular meals and rest times, moderate exercise, and time for enjoyable activities can be important in taking care of yourself and your family physically, emotionally, and psychologically. Avoiding excessive alcohol, drugs, and other destructive 'coping' mechanisms is recommended. For some people, a return to work is very stabilising, but making major life changes such as change of jobs or career will only increase stress.

Lastly, healing rituals are a time-honoured tradition for resolving trauma. Many cultures have used rituals to help people make transitions and give people a sense of tradition and stability. Example of rituals include: writing in a journal regularly, attending some religious or spiritual services or gatherings, meet with fellow survivors to mark formally the passing of the event and affirming the hopes for the future, or burying a symbol of the traumatic event, locating it firmly in the past.

Feeling disconnected or stuck in distress

Some people get stuck in post-traumatic experience as if they are 'frozen in time,' that is, they repeat the same feelings, thoughts, actions, interactions, images, and so on, over and over. One way to get unstuck is to change any part of the repeating pattern in any small way you can. Focus on some other image, change one small action, think something different, change your language slightly, and so on, to break yourself out of the 'frozen in time' negative state. Typical examples might be changing the order in which you recall the events, or consider them from someone else's perspective, or changing the way or when you do any practices that have arisen from the traumatic event. Thinking can be changed from 'all or nothing' thinking (e.g. 'It's a complete disaster') to thinking that puts things more into proportion and includes other elements ('It has been extremely difficult and we are moving on'). Notice the times when you are doing things that work and are useful to you rather than focusing on those that don't work. Literally do more of the useful actions.

Some people disconnect in the wake of a traumatic event, disconnect from themselves internally (from their bodies, their feelings, their memories, and so on) or disconnect from others and the world. If you have the sense that you have disconnected and that is part of the problem for you, you may want to take some small steps to reconnect. You might draw upon what you have done in the past to connect with yourself or others (get a massage to reconnect with your body, call a friend and make a lunch date to reconnect with others, and so on). Connecting with those who have had similar experiences seems to be particularly helpful.

Children and trauma

Children react to traumatic events in many ways ranging from regression to earlier behaviours, to increased tantrums or withdrawal, to poor performance at school. Here are some ideas that may help parents support their children:

• Spend more time with children and let them be more dependent on you during the months following the traumatic event - e.g. allowing your child to cling to you more often than usual. Physical affection is very comforting to children who have experienced trauma.
• Provide play experiences to help relieve tension. Younger children in particular may find it easier to share their ideas and feelings about the event through non-verbal activities such as drawing.
• Encourage older children to speak with you, and with one another, about their thoughts and feelings. Respond to questions in terms they can comprehend. Reassure them repeatedly that you care about them and that you understand and take seriously their fears and concerns.
• Keep regular schedules for activities such as eating, playing and going to bed to help restore a sense of security and normalcy.

Adapted from 'You say you want some resolution' by Bill O'Hanlon, M.S. LMFT. C/- Possibilities, 551 W. Cordova Rd. #715, Santa Fe, NM 87505, Telephone: 800.381.2374, fax 505.983.2761, website:Additional material from the APA Helpcentre: helping.apa.org/daily/ptguidelines